Background Life expectancy is shorter and mortality from cardiovasculardisease higher among blacks than among whites in the UnitedStates. We studied whether place of birth was associated withmortality from cardiovascular causes among non-Hispanic blackand white residents of New York City.
Methods We linked mortality records from 1988 through 1992 with1990 U.S. Census data for New York City. Mortality data forblacks born in the U.S. South and Northeast and in the Caribbeanwere compared with those for whites born in the Northeast.
Results Among blacks, the rates of overall mortality and mortalityfrom cardiovascular causes exceeded those among whites. Amongpersons born in the Northeast, the rates of death from cardiovasculardisease for white men (285 per 100,000), as compared with blackmen (299), and for white women (155), as compared with blackwomen (165), were similar. However, Southern-born black menand women both had mortality from cardiovascular disease thatwas substantially higher than that of their counterparts bornin the Northeast, and Caribbean-born blacks had rates substantiallylower than their Northeastern-born counterparts. The differencesamong the groups in the rates of death from coronary heart diseasewere greater than those for death due to stroke or hypertension.In each category defined by age and sex, Caribbean-born blackshad significantly lower rates of death from coronary heart diseasethan did whites. Black men who were 25 to 44 years of age andwere born in the South had a rate of death from coronary heartdisease that was 30 percent higher than that of Northeastern-bornblacks, and four times that of Caribbean-born blacks of thesame sex and age.
Conclusions The higher rate of mortality from cardiovascularcauses among blacks, as compared with whites, in New York Citymasks substantial variation among blacks based on their placeof birth.
Source Information
From the Department of Epidemiology and Social Medicine, Albert Einstein College of Medicine, 1300 Morris Park Ave., Bronx, NY 10461, where reprint requests should be addressed to Dr. Fang.
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